Provider Demographics
NPI:1891365052
Name:RYAN STERK INC.
Entity Type:Organization
Organization Name:RYAN STERK INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:STERK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:505-459-1245
Mailing Address - Street 1:1513 CARLISLE BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5685
Mailing Address - Country:US
Mailing Address - Phone:505-881-7373
Mailing Address - Fax:505-881-5096
Practice Address - Street 1:1513 CARLISLE BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-5685
Practice Address - Country:US
Practice Address - Phone:505-881-7373
Practice Address - Fax:505-881-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty